Rhinitis is a condition where you get stuffy and/or runny nose, itching and sneezing that are cause by irritation and congestion in the nose . It is divided into acute and chronic rhinitis. If the symptoms persists for more than six weeks it is classify as chronic. Chronic rhinitis can be further divided into allergic and non-allergic rhinitis.

1) Non-allergic rhinitis: The symptoms of non-allergic rhinitis are similar to those of hay fever (allergic rhinitis), but no allergy is involved. It usually happens on and off all year long.

2) Allergic rhinitis: It is an allergic response to moulds, house dust mites, animal dander, chemicals, foods, perfumes, car deodorant etc. Our body response to the allergen is mostly controlled by the mast cells. The mast cells release histamines which cause dilation of blood vessels, redness of skin and swollen membranes. When this occurs in the nose, the symptoms of allergic rhinitis are manifested.

3) Vasomotor rhinitis (Idiopathic/irritant rhinitis) occurs as a result of a response of the nasal membrane to irritants such as smoke, changes in temperature and stress. Other causes of chronic rhinitis are blockage in the nose e.g. nasal polyps, enlarged adenoids and a deviated septum that impede mucus drainage and restrict air flow. Medications can cause rhinitis or worsen it in people with allergies, vasomotor rhinitis or a deviated septum. Prolonged use of nasal decongestants can worsen rhinitis. Some blood pressure medications such as beta blockers and vasodilators can cause rhinitis.

4) Hormonal changes in pregnancy cause “Rhinitis in Pregnancy”. The expecting mother will recover once the baby is delivered.

Sign & Symptom
Symptoms of Rhinitis include sneezing, rhinorrhea(runny nose), nasal congestion, and itching of the nose, palate and ears: eye irritation, itching and headaches.

Complications
In severe and persistent non-allergic rhinitis, complication that may develop such as:

Nasal polyps. These are soft benign growths that develop on the lining of nose or sinuses due to chronic inflammation. Small polyps may not cause problems, but larger ones block the airflow through nose, making it difficult to breathe.

Chronic sinusitis. Prolonged nasal congestion due to non-allergic rhinitis may increase chances of developing sinusitis an infection or inflammation of the membrane that lines the sinuses. Sinusitis causes pain, tenderness and swelling around the eyes, cheeks, nose or forehead.

Middle ear infections. Increased fluid and nasal congestion may lead to middle ear infections.

Rhinitis Treatment

Medical
*Anti-histamines: It provides good relief for mild to moderate symptoms. Newer antihistamines that are long-acting and less likely to cause drowsiness have been found to be useful.

*Decongestants: It is helpful in reducing symptoms such as nasal congestion.

*Corticosteroids: Usually in the form of nasal spray to reduce the immune response. It is usually prescribed to reduce frequency of symptoms.

Surgical
Rhinitis that are due to structural problem like nasal polyps, enlarged adenoids and deviated septum can be corrected with surgery.

Prevention

Avoidance of allergens is the best treatment in allergic and vasomotor rhinitis. Try to avoid pets, carpets and keep house clean from dust. Please do not smoke and choose a non-smoking environment. Complete avoidance of environmental allergens may be impossible but it can be minimised to prevent from another attack of rhinitis.

Rehabilitation

In more severe or difficult to manage allergic rhinitis, patients should be referred to an allergy specialist for immuno theraphy assessment.(In gradual increasing dose of allergen to induce a degree of immune tolerance.

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